Be Kind to Cyclists

With the threat of global warming, many people are thinking about things that they can do to alleviate the burden we place on the earth. Hybrid cars, electric cars, biofuels, we are starting to hear these terms thrown around in everyday conversation; however, each of those cars still consumes the amount of fossil fuel it takes to build each individual part and to assemble them and produces the associated emissions. The fuel consumption and emissions that go into building a new hybrid car makes it less efficient and environmentally friendly than driving a used compact car that runs on petrol. Riding a bike does not consume fossil fuels or produce emissions. The costs to the environment of creating the bike are balanced out by their zero emissions and zero fossil fuels existence. And, if you buy a used bike, you don't even have to incur the environmental costs of manufacturing. This comes down to my main point: biking is best. Therefore, car drivers should respect cyclists' right to be on the road.

I cycle 5 days a week to school 12 months a year. Rain, snow, sunshine. Almost everyday that I ride my bike on the road I am scared for my life because cyclists are not respected by cars. I stop for stop signs, red lights, pedestrians, and in exchange for following the laws of the road, I demand the respect of others on the road. I have only been hit by a car once, which is quite enough, but I have been cut off, had people fling their doors open right infront of me, had pedestrians step out off the sidewalk right infront of me, been squeezed off the road, and have had quite a few side mirrors brush my sleeves. Here are some tips for motorists:

1) Slow down when you are passing a cyclist - not only is it better for the cyclist you are passing, but it also warns the cars behind you that there is a slow moving vehicle on the road

2) Change lanes if there is not enough room to pass with at least 2 feet between you and the cyclist. There is no prize for getting as close as you can to a cyclist and staying in your own lane. think of them like a scooter - you wouldn't try to pass a scooter in the same lane would you?

3) Respect our judgement on how far we ride into the center of the road and don't try to crowd us into the curb. Some roads have depressed road grates that can be dangerous for cyclists and we move out to avoid them or, if there are people parked by the side of the road we leave enough room for their doors to open so we don't get "doored" (see tip 4)

4) Look before you throw open your door. A cyclist is easy to miss if you're not looking for one, do you want to be responsible for injuring another human being? do you want to have your car door damaged?

5) Thank a cyclist for their zero consumption and zero emission mode of transportation while you drive around your personal contribution to global warming. We're doing it for you and your children as well as ourselves and our own.

Dirty Skipper

I just couldn't make myself go to school this morning. Having a guy who specializes in stem cell research teaching us cardiac physiology is just too painful. And then a 2 hour "lab" that involves looking at plastinated specimens that I won't remember anyways. I'm planning on spending some time reading cardiac arrhythmias this morning and trying to get a handle on heart block and then I have to go to PBL (problem based learning).

My school does PBL every semester that we have lectures. For the most part, I kind of like it because it's a good time to review and solidify my knowledge about the subjects taught in class and to get an idea of the literature available on a variety of subjects. Some of the people in my class HATE PBL passionately. They see it as a waste of time and full of "stupid" sociological concerns and questions. I have to say though, one or two people who hate it can bring the group down hugely. It's too bad it's manditory to show up because sometimes I'd rather that some people didn't.

My group this semester is really good, but our facilitator really isn't very good. He doesn't understand that the point of a PBL facilitator is not to offer all of his own knowledge but for him to keep the group moving and allow us to explore our own questions and steer us to the questions mentioned in the outline he is given. He spends half of each session talking and we run over time every week. I like PBL but I want it to be efficient. I like to get things done and keep them moving and I often feel like I don't have all of the time in the world. Each case comes with a tutor guide telling the tutor which subjects we should address and what the diagnosis is. My tutor doesn't read the guide, therefore, two weeks ago we missed 4 topics we were supposed to discuss and missed the correct diagnosis. Although one of my group members suggested it, our tutor brushed it off because he had never heard of it. I hope this improves in the future. It would be a shame to diminish the learning experience by missing topics and hearing our tutor drone on about the same thing week after week that I'm sure he forgot he talked about the week before.

Oh Marks

So, I got my marks today. I did a lot better than I'd thought. I got honours again, BIG releif. I'm not sure if there are any other schools, especially those not in Canada, that work on this strange system. Under 60 is a fail, 60-80 is a pass and over 80 is honours. We never actually get our numerical marks, we just get a F, P, or H on our transcript. Sometimes it's frustrating and sometimes it's great knowing that a few percentage points don't make a huge difference unless you're on the cusp of the boarders between the marks. I always tell myself that I don't care as long as I pass, but secretly I do and I'm proud of myself for being a straight honours student. Only two more semesters with these stupid exams to go and then clerkship! I'm really looking forward to it although it's a scary thing.

Teen Pap Smears and my new profile pic

For Med school we have to do a community project. My group is making posters and a pamphlet giving teens information about pelvic exams for nurses who run a health clinic at a local highschool and for the local health unit. I just finished two of the posters, let me know what you think!



And, for those of you who are confused by new profile pic, I've been thinking a lot about the uterus lately. Seemed appropriate. GO to : http://iheartguts.com/

Family Medicine - Yours To Discover

Wow. I just came back from the GREATEST family medicine talk. We had a couple who are married and both family docs come in to talk to our family medicine interest group about their lives. It was so enlightening. Did you know that with a Canadian family medicine certification you can be licensed to work almost anywhere in the world without taking a test? You can go do locums is many interesting places. They've been to New Zealand, St. Lucia, Bosnia, Serbia and lots of places in Canada including Iqaluit and Sioux Lookout. They both have extra qualifications in anesthesia, the husband does lots of obstetrics including sections and they both do ER in small towns they visit including medevac. I can't explain how much this makes me want to do my family medicine residency RIGHT NOW and just get out there and practice. The opportunities seem endless. This is what makes medicine the best profession in the world.

I think I've pretty much decided that I want to do family medicine. The lifestyle and the flexibility are so appealing to me. Maybe I'll do a PGY3 in obstetrics to fulfill my desire to be involved in pregnancies and deliveries - but then again, you can do that just having your 2 year cert too. Man, I'm so high on family med right now! My new difficulty - urban or rural program for residency???

A Poll

Ok, a friend of mine asked me to post this on my blog after her boyfriend did something incredibly stupid. Here's the burning question/scenario:

Scenario:
A guy kisses a girl in the summer (August) and then he goes back to where he's from (a far awayish city) and carries on emailing her 3 times a week from August until January. Girl plans a trip on an airplane to visit guy in January. Guy does not indicate that he is dating another person as of November.

Quesion:
In your opinion, is it reasonable for the girl to expect that the guy is interested in having some sort of romantic encounter when she arrives for her visit?

Let me know what you think, oh public!

Yoohoo, Douglas Coupland ... your book sucks!

Dear Douglas Coupland,
What were you thinking when you wrote this book? Did you think that if you wrote another Microserfs, nobody would notice? Are you John Grisham? Maybe it's all a money making scheme, put out a new book assuming all those who liked 'serfs will buy it, who cares if they like it once you get your cheque.

What's up with putting yourself in this book as an asshole. I loved Microserfs but this book is driving me nuts. Too much computer code, too many pages wasted to junk and 100 000 digits of pi. At least the side story in Microserfs was about Jed and Daniel's subconscious world. Did you run out of ideas for novels? The characters are likeable and interesting but all the other crap takes away from the ability to develop them fully.

I'm going to read the last 50 pages but I don't think they can possibly make up for the load of suck so far. I'm going to have to go back and read Microserfs again to make up for this travesty.

Snow!

Ok, so the snow finally came this weekend. But, so did freezing rain, and rain. All in all, it added up to hard slogging to get to school on Monday. I'm a cyclist and I bike all winter. Usually it's ok because the roads here are mostly plowed. On Monday, however, nothing was plowed. Riding a bike in fresh snow is like riding a bucking bronco. You slip and slide and it takes a lot of balance to keep on the bike. I did live to tell the tale though.

I've been snowboarding so far 4 times this season all of which were teaching expeditions. Ben is getting a lot better and soon he's going to start going by himself to practice during the week. Hopefully soon I'll get to do some serious boarding on my own so I can try out my new board. It's really fun to board with Ben and watch him improve, but sometimes I feel I'm starting to lose my own skill!

Well, I'm off to do laundry, it's been a busy week so I'll update more about that tomorrow when I don't feel so exhausted!

Swamped

It's only week 3 and I feel pretty swamped with work. This semester is the big 3: nephro, resp and cardio. It's nice to finally get an understanding of how the vital organs work to a certain extent but putting all 3 together was someone's idea of a funny joke. In some ways it's good though because it's forcing me to keep up with things as they happen. I actually did some work last week which is a new thing for me at the beginning of the semester.

In good news, I won an award of merit for my contributions to the medical school community. I'm guessing this is due to my efforts in starting and maintaining the family medicine interest group at my university. I was nominated by one of my peers and I get a free dinner this week because of it. It really makes me feel good that someone noticed how much work I put into this group and it makes me want to keep doing it!

Drugs like Candy

I don't usually spend my food money on magazines, thus I usually only pick up a "women's" magazine once a year when Santa brings me one in my stocking. This year's mag was "Jane", a publication that I usually find harmless and sometimes humorous. This year's January issue, however, had something very disturbing in it. There was an article called "Herbal tea is for weenies" in which a "journalist" compares herbal remedies with pharmacotherapy for "stress".

I was flabbergasted to know that this person managed to get prescriptions for xanax, klonopin and a beta blocker for the sole purpose of writing a magazine article. Furthermore, the "stressful" situations this author was put in were all things that were part of their job, i.e. interviewing celebrities or part of every day life i.e. visiting a friend in prison. I have an idea, if you're SO stressed out by being a journalist; why not just quit your freaking job? Not only did this person consume all of these drugs but they also gave a few of their beta blockers to a friend... it's always a good idea to share your prescription drugs... not.

Even the premise for the article is stupid. People who take herbal supplements by in large are not taking them because they think they're going to work the same way as a valium does. Lots of people take herbals because they don't want to consume or don't think their stress is bad enough to need drugs. Who in their right mind needs a comparison between an aromatherapy arm patch and klonopin done by a journalist to know that the klonopin might give you a stronger effect?

And yes, lets remember, these are drugs. Controlled substances, for which you need a prescription. They're not something to be taken lightly. The article makes light of popping pills for every normal daily stressful event and encourages people to borrow drugs from friends. I found the whole thing disgusting.

Interlude

Medical school lecturers are funny (more in a funny frustrating that a funny Ha Ha way). No matter how much time they're given for a lecture, they always want more so they try to cram in twice as much stuff as they can teach well into the lecture slot. Thus, everything gets taught badly. We've just started nephrology and I can tell you, after half a week of whirlwind lectures I'm already starting to feel lost. At least our physiology lectures made sense to me, but we got a lecture today on fluid balance and IV fluids and the woman talked so fast that nobody understood what was going on. Reading over my notes, some contradict what we were previously taught. i.e. her notes say: if you want to give someone salt and water give half-strength saline. I would interpret this as saying that for someone who is hyponatremic give half-strength saline. This is wrong. One should only give hypotonic solutions when someone is hypernatremic because they lower the serum sodium and increase intracellular and extracellular water. If I'm wrong, please, someone correct me.

For a woman who harped on and on about IV fluids being the most important thing to learn from the lecture, she sure didn't treat it like it was. Also, if the information is complete on the slides for many topics, maybe it's more worth spending time on difficult/unclear subjects rather than reading off your 15 pages of slides (6 slides per page).

We also had a lecturer who gave us a sheet of problems to work through in renal physiology and he couldn't do one of his own problems... which makes it doubly difficult for the rest of them to do them!

A tip to medical lecturers: if everyone looks lost, they probably are!

Revelations

These are things I thought about or learned today:
1) Do not drop your phone in curry - it gets into every little crevace
2) when other people cry, it makes me cry - why?
3) I can't stop eating before I feel full but when I feel full it's like I instantly feel like I'm going to puke - there's no such thing as a little bit full to me
4) When is Grey's anatomy to going start again with new episodes? I had a great Grey's dream the other day...
5) How come the guys downstairs shut off our heat when they went on vacation - did they not think that someone else might be in the house before they got back?

I'm freezing!!!!!

Engineering and Medicine

I recently read a post over at that mirror belongs to frank in which the author puzzled about students from engineering wanting to go into medicine. I'm an engineer with both an undergraduate and a masters degree in bioengineering and yes, I always knew I wanted to be a doctor. Quite frankly though, I thought normal biomedical degrees were A) boring and B) less likely to get me into medical school because I would look like every other joe shmoe applicant.

I took the usual courses in biology, microbiology, physiology, chemistry, physics, biochemistry plus lots of other interesting things that run of the mill premed students are never taught: biosystems design, bioreactor and bioprocess design, differential equations (well, ok, that one wasn't very interesting), biomechanics, mechanics, heat and mass transfer, design, and the list goes on. And you know what? The courses that taught me the most stuff that has helped me in medical school were my engineering courses.

How can that be? Well, most of the mindlessly memorized information from my undergrad I forgot. What stayed with me was the ability to problem solve, find information in books and from other resources, talk to people and work with people, and think about things in non-conventional way. These are skills taught in engineering. As an honours medical student I can honestly say that not taking a biomedical science degree has not hurt me and it has helped me in ways I could have never imagined.

Yes, maybe medicine would be better if we decided in high school what degree we wanted to do and we went through a 6 year medical degree, but then we would miss out on a whole pool of applicants from unique backgrounds who will make great doctors. In my opinion, most of the learning in medical school occurs in clerkship. I think this is a profession that would benefit from more apprenticeship style learning. Clerkship is great because it takes what you've learned in the classroom in whirlwind style and solidifies it in your mind. Maybe med school should be 5 years with one additional year in clerkship. Maybe we should just attend school during the summers so more time can be allotted for clerking. I don't know.

All I know is that you can be an engineer who loved engineering but wanted to be a doctor.

I think that orthopedic surgeons are really mechanical engineers in disguise. I think that nephrologists are chemical engineers who work in the realm of medicine. I think physiatrists are biomechanists hiding out in white coats. Maybe you just have to be an engineer to understand where I'm coming from.

Note: for those of you who don't know what the ring at the top of the post represents you can read about it here.

I'm Baaaaaaaaaaaack

So,
I'm back from my vacay. I snowboarded for 3 days, ate and drank way too much for 3 weeks and slept many nights in a bed with my lovely lovely man.

We nearly didn't make it to 12:00 on new year's night because... we were sleepy. Mom and Dad and Ben and I spent between Christmas and New Years at the cottage. The only slope with snow in this whole province with more than 1 run open happened to be just down the road. I spent most of the three days teaching Ben how to snowboard (he'd been once before and now owns all the kit so I thought he should know how to do it :) and took a few runs on my new board (ooooo do I ever love it). Meet my new lover:I'll say more about my vacation later but first I wanted to say, if you're thinking of making cupcakes you should make the fairy cakes with butter icing from Nigella Lawson's How to be a domestic goddess. You can make them entirely in a food processor (icing and all) and they taste DIVINE. MMmmmm.

B H 90210 Christmas Special

I have a special place in my heart for Beverly Hills 90210, as I eluded to in an earlier post. This morning I watched the BH Christmas special. It actually made me cry. They take in a homeless man for Christmas eve and he turns out to be a man whose wife died the previous year and he took to the streets to try and re-find the meaning of Christmas. I'm sappy, I know. But dude, watch it, I swear, it will make you feel Christmassy!

Jingle Bells, Jingle Bells, Jingle all the way....

Please Snow

It's been 2 years since I've been home for Christmas and this year I thought I might get a white Christmas. I was mistaken. As I gaze outdoors it looks more like Scotland here than it does Canada. Drizzle, drizzle, drizzle. Santa is going to have a hard time with take-offs here, higher coefficient of friction between the sleigh and the roof. I hope he has an on-board computer to help with the new calculations!

Ben is very disappointed that his first Christmas in Canada is going to be a wet one not a cold one. We took him out to pick a Christmas tree the other day. Man, the Scots do NOT know anything about trees. He tried to pick 3 yellow ones, one covered in pine cones, and one where the actual branches didn't start until 2 feet off the ground. Jeeze. We finally found a beauty and cut it down, took it back to the car and brought it home to decorate. I'll put a picture up when I'm back at my parents' house and get a chance to snap one. The tree smells so good, it has a slightly lemony scent and just fills my parents house with happy Christmas memories. It's full of our ornaments ranging from childhood crafts to a beautiful hand made glass star on the top. Christmas has arrived!

I'm staying at Ben's house right now until this evening when we'll descend on my parents' house until boxing day. Ben's at work so all I do all day is watch what not to wear and eat Kraft dinner. It's not as fun as it sounds. I've even lowered myself to doing his laundry and cleaning his room out of boredom. I go out and shop and make fancy dinners because otherwise I think I might die of loneliness. Being a housewife isn't all it's cracked up to be and I don't think I'd be able to do it for long. I'm glad he's off until new years starting tomorrow!

Merry Christmas and Happy Holidays everybody!

Holiday Time

Ah, Christmas. The time when people fill the malls and try to kill you in the subway with large boxes and packages they are wielding with careless joy. I'm trying to relax and enjoy the holiday and forget about my awful exam. It's not happening yet, but hopefully it will by Sunday.

This holiday has been a sad one for my grandmother. Her last living sibling died a few days ago and she has found herself the last survivor of the family she grew up with. I was speaking to her on the telephone and she reminded me that, as the youngest, I would probably also be the last one left of those I grew up with. She called the it curse of being the youngest child - never alone until everyone else has gone. It's hard to listen to someone who has always been upbeat and happy talk about such depressing things. She still has her husband and her children and many grandchildren but it is almost like she's decided that her life is over. She told me that if I was busy not to come visit over the holiday because she's already had her fair share... Of course I'm going to go visit but it's sad to hear someone talking that way. I hope she gets out of her rut soon. I think part of it is that she's surrounded everyday by people who are older and more ill than she and my grandfather are because they live in a retirement community. I hope it is just part of the mourning process and doesn't spill over into her long-term outlook on life.

In good news, I'm almost finished my Christmas shopping and all my sibs are coming over on Christmas day along with their spouses and my darling cute nephew. I am making trifle and Christmas log (a family tradition) and we are going to stuff ourselves silly. Mmmmmmm!

Happy holidays everyone.

Well.. it's an end... not the one I was hoping for

So,
Our practical today was BRUTAL. Last year's practical was so easy compared to ours. Why do I need to know the layers of the vocal folds? WHAT THE HELL. I can see needing to read an audiogram or look at a red eye, but the fucking layers of the vocal folds? kill me now. We all started laughing when we saw the question because nobody knew it, no one. I also didn't recognize that the histology slice we were given was the pons, oops. there goes another 10 marks. So, basically, I hope I did well on the short answer or I might be revisiting neurology in the summer.

But, I'm done. Now it's time to break out the christmas music and the white wine. Medstudentitis is home!

fried brain

This is what my brain looks like. I still have another exam tomorrow and my brain is fried. I just had my long-answer exam and it didn't go as well as I'd hoped. They always put on the things I didn't really study that well! mild cognitive decline... uh ... uh...

I'm tired of writing exams. I'm going to go join the circus.

PHEW

One down, two to go. I'm glad I read over all of my notes last night, there were a few things I didn't know but I think I knew at least 80 out of 110 questions for sure. That may sound like not too many, but it's enough to pass! Then figuring into the average guessing (1/5) that's 86/110, minus ones I thought I got right that I didn't, back to 80. Whew. All I need is a 60 to pass.

I almost crapped myself this morning FYI.

So...

So, the exam is tomorrow morning. You may wonder why I'm writing in my blog at a time like this but I've been sitting on my ass since 8:30 this morning going over my notes that I finished yesterday. I'm taking a break :) My brain is very very very full and I'm not sure how much good this is doing me but I'm doing it anyways because if I don't read over everything (all 14 weeks) today, I know I'm going to regret it later. So, I'm on page 195 of 303... but I'm almost done neuro so that's half the battle. Psych is going to be the fastest read-through ever.



And, in different happier news, my friend Amy is getting married. I'm so happy for her I could burst with happiness. Maybe Ben will get off his "I'm not getting married" horse sometime and ask me to marry him - but I'm not holding my breath (as a child would if they had breath holding spells - not seizures, or as someone had paradoxical vocal cord opening would). Amy is the person I think out of all my friends who probably deserves a great guy like Brian the most. So, this one's to Amy!

This is the part where I sing a silly drinking song that Amy and I both experienced during our undergraduate education together, you ready?

Here's to Amy,

She's a horses ass.

Why was she born so pitiful?

Why was she born at all?

She's no fucking good to anyone,

She's no fucking good at all!

(chorus)

Sooo... drink motherfucker, drink motherfucker, drink motherfucker, drink.

drink motherfucker, drink motherfucker, drink motherfucker, drink.

Chug one for me Princess Amy!!!!

Kind of like

It's kind of like that 90210 episode where Brenda and Kelly both show up for the spring dance in the same outfit and they're really mad at each other because they both said they didn't want it. That disappointment is kind of what reading old exams and finding out you can't answer any of the questions is like. Except the exam thing is 200000000 x worse.

I have a lot of work to do tomorrow. I'm exhausted but I guess I should stay up and finish reading over ophtho and ENT as I'm sure I won't have time to get to them tomorrow and they are at least part of the exam. Ugh.

I guess all I can hope for is that this will turn out like that episode of 90210: Brenda has sex, Kelly is elected Spring Queen and Steve has a mental breakdown because Kelly forgot his birthday. I plan to be the Steve of the situation.

1 day until stupid exams.

Damn Hands

My hands are seriously getting me down. They're like the man. Only they're attached to my body. They're holding me back from my studying potential. I need a robotic right hand. I've never written so much that I'm totally crippled and it's still 2 days until the exam.


Ahhhhhhhhhh 2 days!

I really should be...

I really should be starting on psychiatry. I just finished my first pass of my notes on neurology - i.e. the week a day method of taking notes on notes - my study method. I know it's long and tedious, but I find that it works, so, 8 weeks of neurology in 8 days, not too bad. I'll go over it for a second and third time on Monday and Tuesday as I'm not too worried about ENT and Ophtho for this exam (esp the multiple choice).

Psych is a bit of a funny one - lots of stuff to know i.e. diagnostic criteria but lots of it is common sense. Lots of the disorders seem very similar to me though so I'm probably not going to get through all of it tonight and tomorrow as planned.

Then on to exams Wednesday, Thursday and Friday. Mutliple choice then short answer then practical. Apparently they've had trouble in the past with the projector for the practical so I'm looking forward to that shit show. If there's something to screw up, I'm sure this med school will manage it.

The worst thing about medicine is that you can never throw out your notes after a year like in Undergrad. Well, ok, I was a pack-rat and probably still have some notes on differential equations somewhere from my undergraduate degree, but I have managed to gleefully part with everything that ever had to do with thermodynamics. With my medicine notes, I know that I'm going to have to know all of this stuff for the rest of my life, so I'd better keep the notes around incase I forget it all. I've taken to getting all of my notes bound together so I can recycle binders. I'm cheap and it takes up less shelf space.

Ahhhhh. 3 days until exams.

There is a reason that this bike lock comes with a guarantee of $1000 dollars replacement value for your bike if it gets stolen while locked up (you have to present the cut lock). It really is a good bike lock. For this reason, it was my worst nightmare today when my key broke off in the locking mechanism. It was pretty cold today and had rained last night so my lock had gotten a little iced up. I managed to open it in the morning but went too far in trying to force it open this afternoon. I was at a store getting some pens for my awesome study afternoon when my nightmare began.

This lock is hacksaw proof - believe me, I tried. I was practically crying out in the cold in the snow with my freezing hands and very unhelpful hacksaw when an angel came down from above. Or, a man in a trench coat, but hey, I'll take it. By coincidence he knew a police officer/angel who was also a lock-smith/angel. He called him and the police officer said that by coincidence he was also going to the store I was locked up outside and he would be there in 10 minutes with his tools that he had in his car to take a look. He came, he saw, he couldn't fix but he promised to come back after work with more tools and try to finish the job.

I got a call at 3:30 that not only had he managed to bust open the lock, he also had my bike in the back of his car and was coming to drop it off at my house! When he got here I asked if he still had the lock because of the guarantee and he said he'd thrown it out. No problem, I said I'd call the shop where he cut it off and I'd get them to put it aside. 10 minutes later he calls me back and tells me that he went back and GOT THE LOCK OUT OF THE GARBAGE and is going to DROP IT IN MY MAILBOX later that day!

I mean, who does this stuff happen to? Since when is there a police locksmith magically on hand to unlock your frozen shut no good bike lock when you're in major crisis because you need to get home to study?! This was the worst/very best day ever.

Now, the question is, what kind of thank-you gift can you drop off at a police station for a detective without it looking like a bribe or a bomb?

December 6th

On December 6, 1989, classes were in session at the École Polytechnique at the University of Montreal, located on the north slope of Mont Royal. It was the largest engineering school in Canada, with about 5,000 students enrolled at that time. A six-story yellow brick building housed the classrooms and offices.

To the students it seemed like a normal day, if cold and drizzly. It was the last day of the session, with final presentations going on in different places. About 60 students sat in classroom C-230, on the building's second floor. It was just after 5 p.m., and the sky had darkened. For some, that made it easier to focus on the lecture offered by two students about the mechanics of heat transfer.

Soon after, for 45 minutes, an enraged gunman roamed the corridors and killed 14 women. Marc Lepine, 25, separated the men from the women and before opening fire on the classroom of female engineering students he screamed, "I hate feminists." Almost immediately, the Montreal Massacre became a galvanizing moment in which mourning turned into outrage about all violence against women.

The murdered women were:

Genevieve Bergeron, aged 21;

Helene Colgan, 23;

Nathalie Croteau, 23;

Barbara Daigneault, 22;

Anne-Marie Edward, 21;

Maud Haviernick, 29;

Barbara Maria Klucznik, 31;

Maryse Leclair, 23;

Anne St.-Arneault, 23;

Michele Richard, 21;

Maryse Laganiere, 25;

Anne-Marie Lemay, 22;

Sonia Pelletier, 28; and

Annie Turcotte, aged 21.

These women deserve to be remembered and the horrible act that took their lives NEEDS to be remembered. Violence against women did not start or stop with the Montreal Massacre:

• 30% of women currently or previously married have experienced at least one incident of physical or sexual violence at the hands of a marital partner (Fitzgerald 1999).

• 21% of women abused by a marital partner were assaulted during pregnancy; 40% of these women stated that the abuse began during their pregnancy (Fitzgerald 1999).

• In a recent survey, 12% of women aged 18 to 24 reported at least one incident of violence by a marital partner in a one-year period - 4 times the national average (Fitzgerald 1999).

• One-third of women who were assaulted by a partner feared for their lives at some point during the abusive relationship (Rodgers 1994).

• 45% of women who experienced spousal violence indicated that they had suffered injury, and 43% of these women required medical attention (Rodgers 1994).

• Women married to or living with heavy drinkers, are 5 times more likely to be assaulted by their partners than are women who live with non-drinkers (Fitzgerald 1999).

• Women constitute 98% of spousal violence victims of kidnapping/hostage-taking and sexual assault (Fitzgerald 1999).

These are just the numbers about spousal abuse, many women are also assaulted by men they do not know.

Today I urge you to think about all of the victims of violence against women in the world and to ask yourself what you can do to make a difference. Men and boys are asked on this day and all days of the year to wear a white ribbon. Wearing a white ribbon is a personal pledge to never commit, condone nor remain silent about violence against women.


Fitzgerald, Robin. Family Violence in Canada: A Statistical Profile. Statistics Canada, 1999.

Rodgers, Karen. "Wife Assault: The Findings of a National Survey." Juristat 14, 9. Canadian Centre for Justice Statistics, Statistics Canada, 1994.

My Poor Dented Finger

Last night I went climbing for the first time in a year and a half. I used to be good, now I suck. The picture above is of Ben when we went on a climbing date when we first started dating. He's such a monkey. I think one of my main problems is that I have very sweaty hands. I think it has gotten worse. I go through chalk and re-chalk up more than anyone ever. I think if I went back to climbing a lot I'd have to start using antiperspirant on my hands.

The place was cool, pretty small, but has a chimney climb that's really long. All of the ropes are set up on grisgris so you don't really have to think about belaying or dropping someone. That's always an advantage. I think my shoes shrunk since last time I wore them, or my feet grew, or I'm really not used to the excruciating pain anymore. I think if I was going to get back into it I'd buy new shoes - perhaps not 2 sizes smaller than my feet this time, although it's supposed to make me a better climber it just ends up with me climbing with my arms so I don't put any weight on my sore feet. Anyhoo, today my arms are very sore.

I have also got a study injury, I've managed to totally dent my middle finger on my right hand from all of my furious scribblings. Owie! I'm going to have to learn how to write with my toes.

You know you're going crazy when...

First sign you're going crazy when studying:
You start to read your lectures in the accents of the lecturer. Right now I'm doing it in my head, but I'm sure as soon as I get a bit nuttier I'll start doing it out loud. My medical school seems to have a thing for hiring South Africans - so right now I'm learning about pediatric upper airway obstruction in a lovely South African accent. How come they say trachea so weird? (i.e. Truck-eee-a). It kind of makes me giggle.

Why oh why did I watch Grey's Anatomy tonight instead of studying. I mean, I still studied, but I could have finished what was on my study schedule if I hadn't watched grey's (maybe). Nothing like unrealistic study expectations to make you feel good about yourself. Oh, and finding out there were 14 weeks of lecture not 13 (my whole study schedule hinged on lucky 13).

Guh.

OSCE II

What a freakin' shit show.

You know when they put something on the OSCE that you learned in lecture this semester and haven't studied yet that you're in trouble. Yes, I'm the idiot who confused glaucoma and macular degeneration. Yes, I probably failed that station. Were we supposed to know those things for the OSCE? NO.

We were supposed to be tested in the skills and information learned in our clinical skills and our expanded clinical skills sessions. Macular degeneration was covered in neither. Fundoscopy, yes, strabismus, yes, nystagmus, yes, but macular degen, no. I didn't know we were supposed to have studied everything for our final exam that's in 2 weeks before our OSCE. It's fair game next semester, but not this one. I know I might sound like a whiny loser, but I really did think it was unfair, and so did others.

My lady for the sciatic nerve section didn't know her dermatomes so gave me a very confusing picture of which nerve roots were affected, thus I couldn't answer the question at that station. Fuck. This was awful and I feel like crying. I'm going to be an awful doctor.

OSCE

So, it's coming to the end of the semester and that means it's time for our OSCE. For those of you not in the know, it stands for Objective Structured Clinical Examination. Basically you go through a number of timed stations, each of which consists of a clinical scenario for which you must do a history or a physical exam.

For example: Ted is a 47 year old man who has come in with a complaint of melena. Do a focused physical exam. You will be asked a question at the 5 minute mark.

At this station you would be expected to do an abdominal exam and then a DRE. The examiner has things on a checklist that you get points for doing i.e. light palpation of the abdomen. It's great because every time you do something right you can hear them checking it off - it's a boost of confidence. Unless, of course, you do 5 things and don't head any check marks being made! It is totally artificial and isn't like being with a real patient at all, but it does test your ability to remember which tests to do for what scenario.

I have my OSCE for this semester tomorrow. I'm scared. Mostly because this semester we have had little time to practice our histories and physicals and have instead been focused more on findings, special skills etc. I have to go over my upper and lower back pain exams today and make sure I don't forget something important. I need to remember to FIFE the heck out of people on my history (function, ideas, feelings, expectations) and I need to go over my relevant review of systems because I keep forgetting which questions relate to which clinical scenarios i.e. seronegative arthropathy questions (SOAP BRAIN MD anyone?).

Then I have 2 weeks to study for exams. I started studying a while ago but have sort of lulled myself into a false sense of security and been going pretty slowly. I need to step it up now. 2 weeks to go through a week of notes a day for a total of 13 weeks. I've read the entire textbook but need to start filling in the blanks and reminding myself of what I do and don't know.

MCQ on the 13th, Short answer on the 14th and Practical on the 15th and then I'm FREE for Christmas. I'm excited.

You meet the nicest people in med school

Lately I've been a bit frustrated with a few people in my class (as you could probably tell from the last post). Sometimes, I forget how many nice people there are in medical school who I would have never met otherwise. After the latest frustrating incident with a few group members, one of the girls in my group came up to me and touched me on the arm. She said, "Don't worry, I felt the same way too. I like how you looked them in the eye when you were giving your criticisms, that was honorable." It was like it all ceased to matter. Someone had heard what I said and how I felt and she acknowledged that I was upset and needed support. If she wasn't going into pathology, I would want her as my doctor any day!

So, let this be a lesson to us all, great people go into medicine. The wanks are the exceptions, not the rule.

Bad Day

Some people you just can't get along with. You try to give them honest feedback in a group situation being as transparent and constructive as possible, and they take it the wrong way. You try to let them give you open and honest criticism, and they don't say anything and then make sarcastic comments afterwards. They tell everyone else how they love to give feedback and if they have a problem with someone they'll go up to them and arrange a time to tell them how they feel, and then when they clearly have a problem with you they just sit there and act all passive aggressively. I'm sick of it. Grow up.

Making Medicine Sound Good

Today some colleagues and I gave a talk at a conference to a bunch of engineers who might want to be doctors one day. We discussed all of the things you have to do to get into medical school, why it's great to be an engineer when applying, and how we went about getting in. It was all going well until someone asked what it was we didn't know about medicine when we got into medical school. When someone asks you this question, it's hard to make medical school sound good.

When I got into medical school I thought it was going to be awesome: I thought I would get to see patients and learn how to be a great doctor; I thought I would have fantastic classmates; I thought my professors would be great mentors; and, I thought I would fall in love with a specialty that I would do for the rest of my life. For the most part, all of these things are true.

What I didn't know is that I wouldn't get to see many patients until 3rd year, I would have to sit through hours of lecture that were pitched way above my level of understanding and mumbled through by professors who would rather be operating/medicating/sleeping/etc., and that my life would revolve much more around medical school than I ever thought it would. I love medical school, but there definitely are some drawbacks that I never imagined before hand.

I fell in love with rural family medicine and think I would like to do that for the rest of my life, but I'm not always sure. I have some great mentors who are also my professors, but some of them don't really care who I am or what I do. I love many of the people in my class, but sometimes it's a bit claustrophobic to be with them every minute of the day. Alas, medical school like life isn't perfect. And I don't expect it to be.

Professionalism

There has been a bit of a hubub this week at my med school. Last week we had a scheduled session on "career counseling" which not many people attended. I was personally at the family medicine forum in Quebec City representing my school and learning about family medicine promotion initiatives for the coming year. Other classmates were studying, sleeping, doing observerships, cramming in a little bit of exercise, or generally doing anything but going to this lecture. We then got an email later that week from the doctor who was giving the lecture complaining that nobody showed up and telling us that it was unprofessional of us all to miss it.

I wrote him a message saying that I was sorry I had missed it but the lecture only went onto our schedule 2 weeks earlier and I'd already booked my train tickets to attend this conference. Other individuals sent him emails explaining that they preferred to be doing the things they were actually doing at the time and didn't think the lecture was that helpful in the curriculum (those who were concerned about their future career probably went). Then Dr. Career counselor proceeded to flip out and send an email to the entire medical school explaining how our class is full of unprofessional assholes and taking people's private emails to him and cutting bits out of them to demonstrate that we're assholes. He didn't name any names within our class, but it left me scratching my head... Isn't that a bit unprofessional? Isn't it unprofessional to add a lecture to our schedule on short notice and then take it personally when people have scheduled other things for that time slot?

I think all in all this is a very bad situation. If I was giving the lecture, yes, I'd be pissed if nobody showed up. But, I wouldn't send an email to the whole medical school berating the individuals who didn't come and complaining about "unprofessional behavior". Counseling should be optional and on an as per need basis. Lectures on career counseling don't seem very effective to me. But, alas, I didn't go so I have no idea what he said.

We're grown-ups. Everyone in my class already has an undergraduate degree (or at least 3 years of one) and we should be responsible for our own education. The taking attendance malarky that has happened at this medical school lately is stupid. If people learn better at their desk at their house, so be it. If they can pass the exams and interact clinically with patients at an acceptable standard, what's to say that they aren't going to be as good a physician as any of the rest of us? What use is it wasting one's time in a lecture if that is not the way that one learns? Ultimately, one will not pass unless they learn the material, so let us learn it as we see fit.

Why Med Students are Human

Lately I've been having trouble with three things:
1) Wine
2) Cupcakes/Candy
3) Going to the gym

Wine for me is greatly connected to time spent with friends/family having fun and being care-free. My family loves wine and loves to discuss wine and go on wine tasting/buying trips. I don't drink very often (maybe 2/3 times a month) and if I go out to a restaurant I only ever have one glass. The problem for me is when there's a whole bottle just sitting there. I drink wine like it's water - I tell myself that I should alternate between wine and water because I'm just drinking wine because I'm thirsty, but I never do. Wine also exacerbates my stomach problems. Alcohol is also not great for weight loss/maintenance (see items 2 and 3) so part of my new commitment to personal health and fitness is cutting down. Wish me luck.

Recently I was at a baby shower where there was far too much wine and far too many cupcakes. I managed to limit myself to one cupcake while there, but dammit, my Mum sent me home with 6 leftover ones! If something is there, I will eat it (or drink it). I tell myself that once they're gone, they're gone, but somthing else always seems to come along i.e. leftover halloween candy. I need to develop more willpower. No more cupcakes. Dammit.

Last but not least, the gym. I always have grand plans to make it to the gym 3 times a week. I usually make it twice. Although I ride my bike to and from school every day it's not enough exercise and I'm not liking what's happenening to my body. With exams coming up I have a hard time seeing myself keeping up with my work-out routine. I need to find something else to do that doesn't involve travelling. The upside is that my gym is in the grocery store so I can't very well go buy groceries without commiting to a workout. Unfortunately, sometimes I just choose to go for a week eating frozen food and everything in cans from my pantry and stealing my roommate's milk instead of going shopping. I guess overall laziness might be more my problem.

So, I guess it all comes down to me needing to get off my growing ass and take care of myself. How come it's always easier to sit here and worry about failing neurology?

Magic

Hand in hand we come
Christopher Robin and I
To lay this book in your lap.
Say you're suprised?
Say you like it?
Say it's just what you wanted?
Because it's yours ---
Because we love you.

Welcome to the world Ari Campbell Good